Comparison of the duration of antihypertensive action of atenolol and metoprolol over a 24-hour period.

The antihypertensive and beta-blocking effect of 100 mg atenolol and 100 mg metoprolol each given once daily were compared using an observer-blind, randomized, placebo-controlled crossover study. Blood pressure and heart rate were measured 22 hours after the last tablet of a 2-week dosing period. Twenty-five patients completed the study. Both drugs caused a significant decrease in supine and standing blood pressure, with atenolol effecting, numerically, the greater reductions. The decrease in standing diastolic blood pressure was significantly greater with atenolol than with metoprolol (p less than 0.05). Metoprolol at 22 hours post-dosing did not differ from placebo in the control of exercise systolic blood pressure (191.1 v 194.6 mmHg): the exercise systolic blood pressure achieved on atenolol (177.3 mmHg) was significantly lower than that achieved on both placebo (p less than 0.001) or metoprolol (p less than 0.05). The heart rates achieved on atenolol were significantly lower than those achieved on metoprolol in similar circumstances (p less than 0.001). It is concluded that, at the doses examined in this study, atenolol is the more suitable agent for the control of supine, standing and exercise blood pressure over 22 hours.